Medical oncologist has prescribed Tykerb 250 mg x 5 times daily for 21 days and Xeloda 500 mg x 4 times daily for 14 days. Not prescribed liver biopsy as it will be risky and would be of no use in his opinion .

Quiries

01) Should liver biopsy be done ? Can HER  2 + ve turn HER  2  ve ?
02) There will be delay in starting chemo till biopsy wound is healed . Will it be harmful?

03) What are other targeted chemotherapy options available for liver metastates?

Hema had liver mets which got reduced/disappered in the latest PET scan.She is on Tykerb/Xeloda combination after 9 infusions of Herceptin.For her bone mets she is continuing Zoletrust infusion once in 3 montths.Hope for the best from the Tykerb Xeloda combination

__________________
PBK
huband of Hema
Metstatic Breast Cancer Stage 4
Left breast cauliflower 25x20cm
ossousmetstatis in vertbrae secondaries L4=L5secondary
nodules in both liver lobes secondary
Diagnosed 10th March 2010
ER/PR-ve
Her 2 neu +++
Taxotrne Zylotec started 16th March
Herceptin added 5th April.9th Herceptin over on 20th Sep '10.Started on Tykerb and Xeloda on 22nd Oct2010TYKERB 4 TAB A DAY XELODA 4 TAB A DAY ONE WEEK ON ONE WEEK OFFZoletrust infusion every 4 months.Lesion in Brain 3D CRT Radiation started on 1st Feb'12 for 20 days ,5 days a week for 4 weeks.Devloped a small lump in breast.Xeloda stopped from 11th April '12.On Taxol.After 3 cycles of Taxol Taxol stopped.Back to Xeloda regime from 3rd July
Herceptin started again on 27th Dec 2012.Xeloda stopped Navelbin added on 7th February 2013.Now on Tykerb Herceptin and Navelbin

Hi Alex
Here's my thoughts, remember I am not a doctor just a patient
1. Biopsy or not? This would not be a standard recommendation I think. Yes tumor biology CAN change but it is not all that common and the procedure is not without cost or risk. Your onc may be taking the "proof is in the pudding" approach which is what mine did. Assume the her2 status is unchanged and monitor effect of the treatment.
2. That said, the procedure has a quick recovery time so won't delay treatment. I started xeloda the next day and could have had the biopsy while on treatment.
3. Tykerb and herceptin are the only targeted therapies currently approved in the US. Others are in the pipeline but would only be available on a clinical trial. Nothing wrong with using the tried and true first.

You didn't ask this specifically but tykerb vs. Herceptin? Current thinking is to switch them up to confuse the cancer. This may be what your onc is thinking. Also, tykerb is a smaller molecule so crosses the blood brain barrier thus may be mire protective of the brain than herceptin which is good

Location: I live in a small town (pop7,000) in rural Spain. I've been living in Spain since 1970.

Posts: 7

Re: Herceptin or Tykerb ?

Herceptin and Tykerb attack the Her2 receptor at different levels, thus they have a potentiated effect. As far as I know there is still no way to determine at which level it will work for you except after seeing the effects. It's not unusual to prescribe both with or without Xeloda.